<?php

$this->load("header");
$this->navbar();
?>
<script type="text/javascript" src="http://ajax.googleapis.com/ajax/libs/jquery/1.5.1/jquery.min.js"></script>
<script>
    function loaddbusers() {
        $.ajax({
            url: '?datetime',
            success: function(data) {

                $("#date").val(data);

                setTimeout("loaddbusers()", 10);
            }
        });
    }
    $(function() {
        loaddbusers();
    });
</script>

<!----<div class="bread_crumb" style="margin-left: 2%">
    &laquo;  <a href="enquiry">Back</a>
</div>-->
<div class="add_div">
    <h5 style="margin-left:15px;color:blue">NEW ENQUIRY</h5>
    <form role="form"  action=""  method="POST">
        <div class="form-group" id="add_field">
            <label for="exampleInputEmail1">Enquiry #</label>
            <input type="datetime" class="form-control"   name="enqdate" id="date"  readonly="readonly">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Student Name</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="name" required="required">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Father</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="father" required="required">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Admission to class/group</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="admtoclass" required="required" >
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Previous School/College</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="preschool" required="required">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Address</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="caddress" required="required">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">street</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="cstreet" required="required" >
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Area</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="carea" >
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Status</label>
            <select class="form-control" required="required" name="status">
                <option>Day Scholar</option>
                <option>Day Boarder</option>
                <option>Hosteler</option>
            </select>
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Phone</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="phones" >
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Mobile</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="mobile" required="required">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Name of the Coordinator</label>
            <input type="text" class="form-control" id="exampleInputPassword1" name="coordinator">
        </div>
        <div class="form-group"  id="add_field">
            <label for="exampleInputPassword1">Remarks</label>
            <textarea class="form-control" rows="3" name="remarks"></textarea>
        </div>


        <div style="clear: both;float:right;margin-left:20px">
            <button type="submit" class="btn btn-success" >Save</button></div>
    </form>

</div>
<?php

$this->load("footer");
?>
